Why cyclists shouldn’t take ibuprofen routinely

If you have pain of inflammation, you shouldn't take anti-inflammatories

June 20th, 2019 by | Posted in Health+Nutrition | Tags:

Throughout a riding season, cyclists could be dealing with a variety of pain. There are the usual bothersome aches and pains that come with riding hard or long. Knee pain is a frequent injury amoung cyclists. Soreness in the back, arms, neck and other parts of the body are far from unheard of amoung people who ride. Crashing in racing an training can also leave your body bruised and bloodied. Taking an anti-inflammatory can be tempting but there are many reasons to stay clear or pharmaceuticals that can have harmful effects on your body.

Phoebe Wright is a 30-year-old American track runner who recently graduated from pharmacy school. To mark the occasion she has been tweeting out information on various medications. In particular, she tweets that “Ibuprofen is NOT harmless. It’s terrible for your stomach and kidneys to take it every day. *Especially* if you are exercising hard.”

She goes on: “If you have to take ibuprofen to train pain-free, please take time off instead.”

Wright points out that occasional use (which means not more than a couple of times a month) is fine, but many athletes pop ibuprofen or naproxen regularly to deal with muscle soreness and the pain of injury, some taking them prophylactically before races or events to numb the pain they know is coming. Then they take more afterwards–even though studies have shown that regular ibuprofen users do not have less pain than non-users and that in fact regular use is associated with higher levels of inflammation.

Acetaminophen (Tylenol) may be more safe but is perceived to be less effective.

Athletes should be aware that ibuprofen, naproxen and other NSAIDs (non-steroidal anti-inflammatories) with brand names like Advil, Motrin and Aleve are not benign. Many studies have linked them to heart attacks, stroke, kidney and gastrointestinal damage, even after short-term use. This research is not new, but many athletes persist in the belief that regular use allows an athlete to train harder, which is not true.

A famous study from 2006 found that ultrarunners competing at the Western States Endurance Run who took ibuprofen before and during the race had small amounts of colonic bacteria in their blood.

New York Times article cited a Dutch study from 2015, which noted that though exercise itself can cause intestinal leakage because blood is diverted from the major organs to the muscles during exertion, the damage is minor and temporary. Unlike in athletes who did not take ibuprofen, in whom the cells of the intestine returned to normal after exercising, in those who also took ibuprofen, cells did not return to normal for several hours. Author Dr. Kim van Wijck is quoted as saying “We do not yet know what the long-term consequences are” of regular ibuprofen use by athletes, and that “ibuprofen consumption by athletes is not harmless and should be strongly discouraged.”

As Wright says, athletes who are in pain would benefit much more from taking an extra rest day, rather than risking their long-term health by popping pain-relievers.

A version of this story first appeared on Canadian Running Magazine.